Clark, Alisha
Clark, Alisha is an sole proprietor health care provider with primary practice located at 3907 Elmonte Ct , Indianapolis IN 46226-5536. She recently has only one registered license in Other Service Providers / Driver, which is considered as her primary health care specialty. Clark, Alisha can be contacted via phone (602) 814-7212.Contact Information
Primary practice address
3907 Elmonte Ct
Indianapolis IN 46226-5536
Phone: (602) 814-7212
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Driver | 172A00000X | Indiana |
Profile Details
| NPI number | 1104477546 |
|---|---|
| LBN Legal business name | Clark, Alisha |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 26th, 2019 |
| Last updated | Sep 26th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104477546 | NPPES |
| Indiana | MEDICAID | 843176537 |
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